Orthodontic bracket with sliding molar distalizer

ABSTRACT

A sliding molar distalizer is provided. The distalizer features a canine attachment bracket, a molar tube, and a rod connected to the bracket and having an engagement end for engaging the molar tube. A hook formed on a portion of the rod receives an elastic for imparting distalization force directly on the distalizer towards the molar tube. An orthodontic tube formed on the attachment bracket holds an archwire that passes through premolar brackets. A buccal push flange lever is formed at a distal portion of the rod for imparting force on the molar tube.

RELATED APPLICATIONS

This application claims priority from U.S. Provisional PatentApplication No. 62/248,020 filed Oct. 29, 2015; the contents of whichare herein expressly incorporated by reference.

FIELD OF THE INVENTION

The present invention relates to the field of orthodontic brackets, andmore particularly to a sliding molar distalizer.

BACKGROUND OF THE INVENTION

A malocclusion is a misalignment or incorrect relation between the 2jaws, maxilla and mandible, and the teeth of the respective two dentalarches. This is often referred to as a skeletal dysplasia characterizedby overjet of the upper jaw and upper incisors, and often requirescumbersome external headgear wear. There are generally three orthodonticterms to describe direction. Buccal-lingually means from the cheek sideto the tongue side. Mesial-distally means from anterior to posterior orfront to back. Occlusal-gingivally means from the bite side to the gumside. Malocclusion or malalignment of the bite, may be classified in oneof three classes. Class I: Neutrocclusion where the molar relationshipof the occlusion is within normal limits. This is described as themaxillary (or upper) first molar mesial cusp fitting into the centralgroove of the mandiubular (or lower) first molar, and where the otherteeth may have additional problems such as spacing, crowding, orvertical alignment issues such as over or under eruption. Class II:Distocclusion where the mesiobuccal cusp tip of the upper first molar isanteriorly or forwardly positioned ahead of the mesiobuccal groove ofthe lower first molar and instead is anterior to it (often called alarge “overbite” or technically a large overjet of the upper teethanterior to the lower dentition). Again, the Class II can be a result ofthe skeletal components of the upper jaw (maxillary segment) and/orlower jaw (mandibular segment) being malaligned or may additionallyinvolve the dentition being maligned (above). Class II also has twodivisions where: Division 1 has molar relationships such as Class IIwith the anterior teeth protruding; and Division 2 has molarrelationships like Class II but the central incisor teeth areretroclined and the lateral incisor teeth are seen anteriorlyoverlapping the centrals. It is important that the upper first molarsare often and generally displaced and rotated mesially in Class IImalocclusions taking up more space in the upper dental arch andcontributing to the overjet, requiring correction. Class III:Mesiocclusion is found in patients where the upper molars are placed notin the lower molar mesiobuccal groove but where the upper molar islocated posteriorly to the lower molar central groove and often referredto as an underbite.

A distalizer applies to the treatment generally, of the upper teeth andupper jaw with a Class II overjet condition above but can also be usedin the lower jaw or teeth by reversing the direction of force to be usedin the correction of a Class III malocclusion.

Distalizers have been used to correct one or more of the malocclusionsdescribed above. One such distalizer is described in U.S. Pat. Nos.6,976,839; 7,238,022; and 7,618,257, which all disclose an auxiliaryelement for the segmented distalization of the posterior jawbone sectorfrom canine to molar in orthodontic treatment. The orthodontic applianceor element includes two components: a mesial segment and a distalsegment. The mesial segment is composed of a rectangular anterior bondedcanine attachment with its bonding base attached and fixed to the enamelof the canine with bonding resin adhesive. This canine attachment has abuccally protruding anterior end, as a horizontal handle-like portionthat facilitates retention of a separate elastic element placed by thepatient individually that is stretched down to a separate mandibularfirst molar attachment on each side so as to produce adiagonally-directed interjaw and inter-arch force (between the maxillaryand mandibular dental arches). This mesial component is finished off byan elongated and arched rod extension that is part of, and firmlyattached off of the distal end of the bonded canine attachment. Theother end of the rod has a flat, disk-shape with a lateral and centrallylocated hole opening, or orifice for a permanent pin that largelypermits rotation in the bucco-lingual direction.

The distal component is a smaller distally (posteriorly) located elementgenerally attached to the upper molar on each side of the upper jaw. Thedistal component is finished off by a shoe-shaped receptacle located inthe middle portion with an outside base that attaches to the tooth. Therod's disk-shaped end member is coupled and permanently pinned with theshoe-shaped receptacle connecting the separate pin of the receptacle tothe distal disk-shaped end of the mesial segment. The permanently weldedpin on either side of the shoe receptacle where the pin is located inthe center of the shoe passes through the housing orifice of thedisk-shaped rod end. A projecting pivot of the receptacle cavity of thedistal segment is placed within a lateral slot of the mesial segment tolimit rotation of the flat disk-shaped member.

These distalizer mechanisms as described above are often complex anddifficult to manufacture in three or four pieces with additionalprecision rotation pins through the rod connecting intricately to thedistal component, and difficult to assemble. The projecting pivot andslot that limits rotation also increases difficulty in assembly. As twodistalizers are used for balance in total, one on the left side and oneon the right side of the upper jaw, a complex distalizer is costprohibitive. Moreover, prior art distalizers are characterized bylateral rotation pins that fixed the mesial segment rod to the distalsegment. These lateral pins result in the force on the mesial segmentbeing applied, and being limited by the slot on the disk-shaped, locatedspecifically on the lateral lingual surface due to the coupling with thereceptacle of the distal segment. This lingual lateral contact of thelateral receptacle pin within the lateral slot of the disk-shape of themesial segment also reduces the moment of force from the centre ofresistance of the molar, (e.g. 94, FIG. 10A), for prior art distalizers.When the pins are replaced by lateral crimping of the receptacle in thedistal segment of prior art distalizers, similar lateral contact forcesare specifically established. Furthermore, when a force is applied atthe level of the molar crown, the crown of the tooth begins to tipposteriorly, which can later, after treatment in retention, result inthe tipped molar crown re-aligning itself under the forward position ofthe root. This is known as orthodontic relapse. In addition, the othermore visible and common complications is that the upper canines canover-erupt due to the elastic traction that poses an aesthetic issue forpatients. For this reason it is preferable and indicated in orthodonticbiomechanics to translate the molar roots, or bodily move, the molarposteriorly by pushing distally closer to its center of resistancelocated near the roots.

SUMMARY OF THE INVENTION

In accordance with one aspect of the invention there is provided anorthodontic appliance for orthodontic treatment of a posterior maxillarysector extending from a canine tooth to a molar tooth on the same sideof the maxilla comprising: a molar tube affixed to a molar tooth andhaving an opening on the mesial side to an interior of the molar tube; acanine attachment bracket component affixed to a canine tooth; a curvedrod extending from the canine attachment bracket component towards themolar tube in a mesiodistal direction; and a hook, located on the canineattachment bracket component or on the curved rod, for attachment to atraction elastic; wherein a distal end of the curved rod engages atleast one surface of the molar tube, such as the distal surface, toexert a distal force on the molar tooth when under a force of thetraction elastic on the hook.

The orthodontic appliance may comprise an engagement feature at thedistal end of the curved rod, and the engagement feature may be coupledto a retention feature in the molar tube. The hook may be located on thecurved rod between the canine attachment bracket component and the molartube. The hook may also be on a curved portion of the rod. The hook maybe smooth in order to reduce catching on the inside of a patient'scheek.

The canine attachment bracket component may comprise an orthodontic tubecontaining an archwire slot therethrough in the mesiodistal direction.The archwire slot may be sized for permitting the insertion of anarchwire to pass generally mesiodistally from the canine attachmentbracket into at least one premolar bracket.

The orthodontic appliance may further comprise a buccal push flangelever, located at the distal portion of the curved rod for engaging amesial end of the molar tube, when the curved rod is moved distallyunder the force of the traction elastic. The buccal flange lever may bebuccally offset with respect to the curved rod such that the buccalflange lever engages a mesial edge of a buccal wall of the molar tubewhen the curved rod is moved distally under the force of the tractionelastic.

The engagement feature of the orthodontic appliance may have a generallyspherical shape, and the retention feature on the molar tube may be aspherical void sized slightly larger than the engagement feature.Alternatively, the engagement feature may have a generally ellipsoidalshape and the retention feature may be a generally ellipsoidal voidsized slightly larger than the engagement feature.

In accordance with another aspect of the invention, there is provided anorthodontic appliance for orthodontic treatment of a posterior maxillarysector extending from a canine tooth to a molar tooth on the same sideof the maxilla, comprising: a molar tube affixed to a molar tooth andhaving an opening on the mesial side to an interior of the molar tubeand an aperture on the distal side; a canine attachment bracket affixedto a canine tooth; a curved rod extending from the canine attachmentbracket in a mesiodistal direction; and a hook, located on the canineattachment bracket or on the curved rod, for attachment to a tractionelastic; wherein the curved rod passes through the molar tube enteringat the opening and exiting at the aperture; and wherein a distal endportion of the curved rod frictionally engages the molar tube to exert adistal force on the molar tooth when under force of the traction elasticon the hook.

The curved rod may comprise a blocking feature at a distal end thereoffor preventing the curved rod from being removed from the molar tube.The hook may be located on the curved rod between the canine attachmentbracket and the molar tube, and more specifically the hook may belocated on a curved portion of the rod. The hook is preferably smooth inorder to reduce catching on the inside of a patient's cheek. The canineattachment bracket may comprise an orthodontic tube containing anarchwire slot therethrough in the mesiodistal direction. The archwireslot may be sized for permitting an archwire to pass generallymesiodistally from the canine attachment bracket into at least onepremolar bracket. A buccal flange lever may be located at the distalportion of the curved rod, for engaging a mesial end of the molar tubewhen the curved rod is moved distally under the force of the tractionelastic on the hook.

In any of the above aspects of the invention, the curved rod may taperat the distal end, the opening of the molar tube may be generallyrectangular in shape with round corners internally and externally, andthe interior of the molar tube may taper in a mesiodistal direction fromthe opening. The interior of the molar tube may be shaped like a pyramidwith round corners, a prism with round corners, or a funnel or cone withrounded end corners. The opening of the molar tube may be narrower in anocclusal-gingival direction than in a buccal lingual direction.Alternatively, the opening of the molar tube may narrow in thebuccal-lingual direction and in the mesial to distal reaction, and maybe relatively rectangular in shape through a cross sectional view in anocclusal-gingival direction. The curved rod may engage a tapered end ofthe interior of the molar tube. The tapered end of the curved rod mayinitially align with the buccal wall of the molar tube, and duringdistalization treatment may become aligned with the lingual wall of themolar tube. The molar tube may comprise at least one restriction featuremaintaining the engagement feature within the retention feature.

The orthodontic appliance may also comprise at least one premolarbracket bonded to at least one premolar, and an archwire placed in thecanine and passing through the at least one premolar bracket.

In yet another aspect of the present invention, there is provided anorthodontic appliance for orthodontic treatment of a posterior maxillarysector extending from a canine tooth to a molar tooth on the same sideof the maxilla. The orthodontic appliance comprises: a molar tubeaffixed to a molar tooth and having an opening on the mesial side to aninterior of the molar tube; a canine attachment bracket affixed to acanine tooth; a curved rod extending from the canine attachment bracket;and a hook, located on the canine attachment bracket or on the curvedrod, for attachment to a traction elastic; wherein the curved rodengages the molar tube to exert a distal force to the molar tooth whenunder the force of the traction elastic.

The curved rod may comprise an engagement feature coupled to a retentionfeature of the molar tube. The hook may be located on the curved rodbetween the canine attachment bracket and the molar tube. The hook mayalso be located on a curved portion of the rod. The hook is preferablysmooth in order to reduce catching on an inside of a patient's cheek.The canine attachment bracket may comprise an orthodontic tubecontaining an archwire slot therethrough in the mesiodistal direction.The archwire slot may be sized for permitting the insertion of anarchwire to pass generally mesiodistally from the canine attachmentbracket into at least one premolar bracket.

A buccal flange lever may be located at the distal end of the curved rodfor engaging a mesial end of the molar tube when the curved rod is moveddistally under the force of the elastic on the hook. The buccal flangelever may be buccally offset with respect to the curved rod such that italigns with a mesial edge of a buccal wall of the molar tube when thecurved rod is moved distally under the force of the traction elastic.The engagement feature may be either spherical or ellipsoidal in shape,and the corresponding retention feature may be a spherical or anellipsoidal void, respectively, each having a size slightly larger thanthe corresponding engagement feature. The engagement feature may also begenerally D-shaped and the retention feature may be a generallysinusoidal void with at least two chambers sized slightly larger thanthe engagement feature. The buccal flange lever may engage the mesialend of the molar tube before the engagement feature abuts the back wallof the molar tube in any and all embodiments described herein using abuccal flange lever.

BRIEF DESCRIPTION OF THE DRAWINGS

The novel features which are believed to be characteristic of thepresent invention, as to its structure, organization, use and method ofoperation, particularly in terms of improved proximity to the 3 maincenters of resistance of the upper jaw and teeth, together with furtherobjectives and advantages thereof, will be better understood from thefollowing drawings in which a presently preferred embodiment of theinvention will now be illustrated by way of example. It is expresslyunderstood, however, that the drawings are for the purpose ofillustration and description only, and are not intended as a definitionof the limits of the invention. In the accompanying drawings:

FIG. 1 is a buccal view of the upper middle and posterior teeth with asliding distalizer in accordance with an embodiment of the presentinvention;

FIG. 1B is a buccal view of the upper middle and posterior teeth with avariation of the sliding distalizer of FIG. 1 along with intermediaryanchor guides;

FIG. 2 is an occlusal view of the sliding distalizer of with across-section through the molar tube at reference line 98, of FIG. 1 onthe upper teeth at an initial phase;

FIG. 3 is an occlusal view of the sliding distalizer with across-section through the molar tube at reference line 98, of FIG. 1 onthe upper teeth that shows a distalization with mild sinusoidal lingualmovement of the distal aspect of the upper molar;

FIG. 4 is a mesial perspective view showing a distal rod end engagingthe upper molar tube of the sliding distalizer of FIG. 1, and initiallyalso aligning close to the buccal surface of the upper molar tube withthe distal rod end contacting the distal back wall of the upper molartube;

FIG. 5 is a distal perspective view showing the upper molar tube of thesliding distalizer of FIG. 1, and how the distal rod end contacts thedistal back wall part of the upper molar tube;

FIG. 6 is an occlusal view of the upper molar tube of the slidingdistalizer with a cross-section through the molar tube at line 98 ofFIG. 1, showing the conical, funnel-shape of the tube opening (dottedlines), and how the distal rod end engages the distal back wall of theupper molar tube attached to an upper molar;

FIG. 7A is an occlusal view of an upper molar tube of a slidingdistalizer, with a similar molar tube cross-section as in FIG. 6,showing a distal rod end having a spherical engagement feature engaginga spherical and funneled, keyhole void retention feature of an uppermolar tube attached to an upper molar, in accordance with anotherembodiment of the present invention;

FIG. 7B is an enlarged version of FIG. 7A;

FIG. 7C is an enlarged horizontal cross-sectional perspective view ofthe upper molar tube that includes the distal rod end having thespherical engagement feature coupled to a retention feature of the uppermolar tube in the form of a funneled, keyhole clasp, pushing distally onthe back wall of the upper molar tube, in accordance with yet anotherembodiment of the present invention;

FIG. 7D is an enlarged horizontal cross-sectional occlusal view of aD-shaped distal rod end and a sinusoidal retention feature of the uppermolar tube following movement of the distal end of the rod, forsupplemental distalization

FIG. 8 is an occlusal view of an upper molar tube of a slidingdistalizer, with a cross-section showing a distal rod end engaging theupper molar tube and passing through an aperture in a distal portion ofthe upper molar tube, in accordance with yet another embodiment of thepresent invention;

FIG. 9 is a buccal view of the upper middle and posterior teeth with asliding distalizer featuring an orthodontic tube, a hook located on therod, and a buccal push flange lever, with the centers of resistance ofthe maxillary dentition, the maxillary first molar, and the maxilla orupper jaw, in accordance with yet another embodiment of the presentinvention;

FIG. 10A is an occlusal view of the sliding distalizer of FIG. 9 on theupper teeth, with a middle cross-sectional view through the molar tubeat an initial phase;

FIG. 10B is an occlusal view of the sliding distalizer of FIG. 9 on theupper teeth, with a middle cross-sectional view through the molar tube,that shows a distalization with mild lingual movement of the distalaspect of the molar;

FIG. 10C is a perspective side view of a distal rod end of a slidingdistalizer featuring a buccal push flange lever coupled to an uppermolar tube with the top gingival wall of the molar tube removed, showingthe retention void in the form of a C-clasp having an aperture in themolar tube in accordance with yet another embodiment of the presentinvention;

FIG. 11A is a mesial view showing the engagement feature of FIG. 9, FIG.10A, FIG. 10B, and FIG. 10C in relation to a molar tooth;

FIG. 11B is a mesial perspective view showing the distal rod end coupledto the upper molar tube of the sliding distalizer of FIG. 9, FIG. 10A,and FIG. 10B;

FIG. 12 is a distal perspective view showing the engagement feature ofthe sliding distalizer of FIG. 10C;

FIG. 13 is perspective buccal-gingival view of a sliding distalizerfeaturing the upper molar tube of FIG. 11B;

FIG. 14A is a buccal-occlusal perspective view of a sliding distalizerfeaturing a centrally located canine tube on the canine bracketattachment or bonding pad portion, a hook and a buccal push flangelever, in accordance with another embodiment of the present invention;and

FIG. 14B is an occlusal side view of the sliding distalizer.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

With reference to FIG. 1 to FIG. 6, a sliding distalizer is provided.The sliding distalizer comprises an angled rhomboid orrectangular-shaped attachment bracket 20 affixed to a canine tooth 10.The attachment bracket 20 has a ball hook 22, to attach a separatetraction force elastic (not shown) to a lower molar at a diagonal inorder to exert force on the attachment bracket 20. The ball hook 22 issmooth in order to reduce catching of the hook 22 on the inside of thepatient's cheek. The attachment bracket 20 may be integrally formed at,or attached to, a portion of a long rod 30 that extends towards the backof the mouth in a mesiodistal direction. The rod 30 is slightly curvedin the buccal-lingual plane, but relatively straight in thegingival-occlusal plane. The rod 30 enters an upper molar tube 40,affixed to a molar tooth 12, via a wide opening 42 on a mesial side,more clearly shown in FIG. 4 to FIG. 6. The upper molar tube 40 may beshaped so that opening 42 is generally rectangular or may have othersuitable shapes, such as an initially flared funnel, an oval, anelliptical, or a round shape, and opening 42 may have a correspondingshape all with rounded internal and external edges. The rod 30, in someembodiments, has a tapered distal end 32 opposite the attachment bracket20, but may be otherwise shaped to engage the interior 44 including theback of the molar tube 40. The rod 30 and molar tube 40 can be made ofstainless steel, chromium-cobalt, or titanium etc., or alloys thatcombine several types of metals.

In another embodiment shown in FIG. 1B, additional anchor-loop guides 60and 62 may be bonded to the premolars to accommodate the rod 30supported by anchor-loops formed on the guides. The rod 30 slidesthrough guides 60 and 62 to allow natural distal drift of the premolarsand secondly to reduce or prevent the complication of inadvertent caninetooth extrusion in the prior art due to the vertical inter-arch elasticforce component, 96, on the canine tooth 10. The premolar anchor-loopguides may be additionally self-ligating to enable easy removal of therod 30.

In FIG. 2 to FIG. 6 the interior 44 of the molar tube 40 tapers (shownthrough a reference plane 98 in FIG. 1 as dot-dashed lines) in amesiodistal direction from the wide anterior or mesial molar tubeopening 42. During initial treatment, better shown in FIG. 2, thetapered distal end 32 of the rod 30 generally aligns close with thebuccal wall of the interior 44 of the molar tube and applies a milddistal force initially to the tapered back or distal wall 46 of theinterior 44. The rod 30 causes the molar 12 to slide distally towardsthe back of the mouth.

Since the upper molar 12 has one large root on the palatal side and twosmall roots on the buccal or buccal side, the molar 12, duringtreatment, begins to move directly distally and partially rotatedistally for a combined, overall distal sinusoidal movement. The molaris observed to largely distalize (move posteriorly) as shown in FIG. 3.As the molar 12 distalizes and rotates, the tapered rod 30 continues toslide the molar 12 distally and gradually aligns approximately with thelingual wall 48 of the interior 44 of the molar tube 40. Once the rod 30aligns with the lingual wall 48, the rod 30 stops any partial rotationof the upper molar 12, however, the upper molar 12 continues to slidedistally.

FIG. 4 and FIG. 5 are mesial and distal views, respectively, showingdistal rod end 32 engaging the upper molar tube 40 of the slidingdistalizer, and initially also aligning approximately with the buccalwall of the upper molar tube. FIG. 6 is an occlusal view of the uppermolar tube 40 of the sliding distalizer, with a cross-section showingthe funnel-shape of the tube opening 44 (in dotted lines), and how thedistal rod end 32 engages the back distal wall of the upper molar tube40 attached to an upper molar 12.

Turning now to FIG. 7A and FIG. 7B which are occlusal views of an uppermolar tube 40 of a sliding distalizer, with a cross-section showing adistal rod end 32 having an engagement feature 50 engaging a retentionfeature 49 of an upper molar tube 40 attached to an upper molar 12, inaccordance with another embodiment of the present invention. Engagementfeature 50 may have a generally spherical shape, and may be integrallyformed on, or attached to, the distal end 32 of the rod 30. The rod 30may be held in the molar tube 40 by the engagement feature 50 being heldin place by the corresponding retention feature 49 of the molar tube 40,such as a spherical void sized slightly larger than the engagementfeature 50. The retention feature 49 may have at least one restrictionfeature 62, (and/or 64) that maintains the engagement feature 50 withinthe retention feature 49. The restriction feature 62, and/or 64 may haveflanges or a narrowing that maintains the engagement feature 50 withinthe retention feature 49 until a sufficient force is applied. When asufficient mesial force is applied, the engagement feature 50 cannotovercome the restriction features 62, 64 permitting the engagementfeature 50 to be retained and engage the retention feature 49 firmly.The spherical shape additionally may be magnetized for retention.

FIG. 7C is an enlarged perspective view of the distal rod end 32 havingthe spherical engagement feature 50 coupled to a retention feature 49 ofan upper molar tube 40 in the form of a funneled keyhole-clasp 49, inaccordance with yet another embodiment of the present invention. Thefunneled keyhole-clasp 49 may feature at least one restriction feature62, or 64 as described above.

FIG. 7D is an enlarged cross-sectional occlusal view of an upper molartube 40 in accordance with another embodiment of the present invention,of a sliding distalizer showing a distal rod portion having anessentially D-shaped engagement feature 50 that engages a sinusoidalretention feature 55 within the molar tube 40. Following a first phaseof initial molar distalization (not shown), the D-shaped engagementfeature 50 has slid mesially out from the initial most distal void 49(dotted line away from with initial retention wall 57), and into thesecond void 44 in a mesial direction. The engagement feature 50 beginsto push distally once again on retention feature wall 55 for asupplemental second phase of the molar tube 40 to maximizedistalization.

Alternatively, in yet another embodiment, the engagement feature 50 andthe retention feature 49 may be larger in one dimension than anotherdirection, such as a generally ellipsoidal engagement feature 50 (FIG.14A, FIG. 14B) and a generally ellipsoidal retention feature 49. Theellipsoidal nature of these two features permits placement of theellipsoidal engagement feature 50 into the retention feature 49 when thetwo ellipsoids are generally aligned and subsequent distalization of theengagement feature 50 within the retention feature 49 secures theengagement feature 50.

In another embodiment shown in FIG. 8, the molar tube 40 has an apertureor hole 51 at the back base of the tapered bottom of the interior 44.The aperture 51 is sized such that the distal end portion of rod 30frictionally engages the molar tube 40 at aperture 51 such that when rod30 is moved distally by force of an elastic from the hook causes molartube 40 to also move distally, with the attached molar 12. In someembodiments rod 30 has a tapered portion 32 such that a distal tip 52thereof fits through aperture 51. The rod 30 has a blocking feature 53affixed to distal tip 52 thereby preventing the rod 30 from beingremoved from the molar tube 40, such as during chewing, etc. Theblocking feature 53 may be crimped-on the rod, or threaded and likewisethe rod 30 may also be threaded at tip 52 permitting the blockingfeature 53 to be screwed onto the rod 30 after placement through theaperture 51. Alternatively, the blocking feature 53 may be integrallyformed or welded to the rod 30 at tip 52 during manufacture of theappliance.

Turning now to FIG. 9, which shows a side-view of the upper middle andposterior teeth with a sliding distalizer in accordance with yet anotherembodiment of the present invention. An angled, rhomboid-shaped, orgenerally rectangular attachment bracket 20 is affixed to a canine tooth10. The attachment bracket 20 features an orthodontic tube 24 suitablefor placing a separate sectional archwire (not shown) through to twoposteriorly-located premolar brackets (not shown) that may be placedabove or below rod 30. This produces an anterior anchorage segment inorder to prevent the aesthetic complication of canine over-eruption.Canine over-eruption is directly due to the vertical vector of theelastic traction force to the hook located at the anterior end of priorart distalizers. This results in a long lever arm away from the centerof resistance of the anchoring molar 94 (in FIG. 9) producing asignificant moment of extrusive force on the canine, with the prior art.The attachment bracket 20 may be integrally formed at the mesial of thecurved, long rod 30 that extends towards the back of the mouth in amesiodistal direction. Alternatively, the attached canine tube 24 may bea separate component welded, brazed, or form-molded into the attachmentbracket 20 acting as a bonding pad to tooth enamel, and suitably affixedto a mesial of rod 30. The long rod 30 has a hook 34 to attach aseparate traction force elastic to a lower molar at a diagonal in orderto exert direct force from the hook on the rod to usually the distalwall of the molar tube. The hook 34 is smooth in order to reducecatching of the hook 34 on the inside of the patient's cheek. In someembodiments, the hook 34 is located on the rod portion of long rod 30.With reference to FIG. 9 and FIG. 10A, the entire maxillary dentitioncenter of resistance (CR) 90, the actual localized upper molar CR 94,and the upper jaw or maxilla CR 92 which is located near the area of thesutural connection between the maxilla with the zygoma (cheek bone), thelatter CR 92 positioned approximately above the posterior roots of theupper molars, are identified. The positioning of hook 34 on rod 30substantially on the rod portion is advantageous as the hook 34 iscloser anterior-posteriorly to the CR of the molar 94, and to the CR ofthe maxilla 92. The hook 34 positioning also improves the opportunityfor more bodily translation of the upper molar 12 to reduce molartipping. The hook 34 positioning additionally improves the restrictionof maxillary growth by being closer to the center of resistance of themaxilla 92 when heavy elastic traction force is imparted directly on thehook 34 by the traction elastic. The hook provides another advantageimparting indirect force and away from the canine anterior end that inthe prior art contributed to the complication of canine-over eruption(dracula-canine) appearance with direct elastic placement to thecanines.

Turning back to FIG. 9, also depicted is a buccal push flange lever 70located on a distal portion of the rod 30 proximal to mesial edges ofthe buccal wall 47 (FIG. 11A) and later in treatment proximal to thelingual wall 48 of molar tube 40. Buccal push flange lever 70 may beintegrally formed with rod 30 or may be a separate component welded,brazed or affixed to rod 30 by any suitable means.

Turning back to FIG. 7A, FIG. 7B, and FIG. 7C in addition, a buccal pushflange lever (not shown, 70 in FIG. 9) can be applied on the rod portionmesial of the molar tube 40 wherein the buccal push flange lever wouldcontact the mesial of the molar tube first before the sphere 50 abutsagainst the back wall of the molar tube.

FIG. 10A is an occlusal view of the sliding distalizer on the upperteeth at an initial phase, while FIG. 10B is an occlusal view of thesliding distalizer on the upper teeth that shows a distalization ofmolar 12. As shown, buccal push flange lever 70 is buccally offset withrespect to rod 30. Accordingly, when the distalizer is moved distallytowards molar 12 by action of the external traction force elastic,buccal push flange lever 70 engages the mesial edge of buccal wallimparting a distalization and rotation force on molar 12.Advantageously, due to the longer distance between the buccal wall andthat of the molar centre of resistance 94, FIG. 10A, the moment of forceabout molar 12 is increased (FIG. 10A), thus less force by the elastictraction force is needed to distalize the molar 12. Furthermore thebuccal push flange lever 70 is closer to the center of resistance of themaxillary dentition 90 (observed in FIG. 9, and FIG. 10A) than prior artcontact in the molar tube that was more posterior to CR 90. In addition,the buccal push flange lever 70 is closer to the center of resistance ofthe maxilla 92 because it is located closer to the cheek as well,observed in FIG. 10A to restrict skeletal maxillary growth.

FIG. 10C is a buccal perspective view of an engagement feature of asliding distalizer featuring a buccal push flange lever, and FIG. 12 isa distal perspective view of the engagement feature, in accordance withyet another embodiment of the present invention. FIG. 13 is perspectivebuccal-gingival view of a sliding distalizer featuring the upper molartube of FIG. 11B. With reference to FIG. 10C, FIG. 12, and FIG. 13, insome embodiments the mesial edges 47 of buccal wall 38 in FIG. 11A, andlingual wall 48 in FIG. 10C and FIG. 11A are flared. In suchembodiments, buccal push flange lever 70 engages a buccal tip of themesial edge of the buccal wall, further increasing the moment of forceas explained earlier. In this embodiment molar tube 40 is C-shaped andhas a generally elliptical aperture suitable for receiving rod 30.

In other embodiments, buccal push flange lever 70 engages the molar tubeat both the mesial edge 47 of the buccal wall 38 and later followingsome distalization, the mesial surface of the lingual wall 48. In otherembodiments, buccal wall 38 is shorter mesiodistally than lingual wall48. Buccal push flange lever 70 can be angled towards the buccal wall 38with respect to rod 30.

FIG. 14A is a perspective view of a sliding distalizer featuring acentrally located hook, an orthodontic tube, and a buccal push flangelever, in accordance with another embodiment of the present invention;and FIG. 14B is a side view of the sliding distalizer of FIG. 14A. Withreference to both FIGS. 14A and 14B, an attachment bracket component 20suitable for being affixed to a canine tooth is shown. Attachmentbracket 20 features an orthodontic tube 24 integrated via welding,brazing or form-molding suitable for supporting an archwiretherethrough. Attachment bracket 20 may be formed at one portion of arod 30. Rod 30 has an integrated hook 34 formed thereon. A buccal pushflange lever 70 is formed at the rod 30 opposite the attachment bracket.An engagement feature 50 is located at a distal end of rod 30.Engagement feature 50 is in the form of an ellipsoid, and is suitablefor coupling with a retention feature having the shape of an ellipsoidvoid, for retaining the distal end of rod 30 in a molar tube (notshown).

Although the interior 44 of the molar tube 40 is shown as a void, thevoid may be filled with a compressible material such as lubricant,polycarbonate, wax, foam or rubber in order to adjust the amount ofdistalization force on the molar 12. Alternatively, the interior 44 ofthe molar tube 40 may be coated with a material such as wax to increasethe friction to reduce slippage between the rod 30 and the interior 44or to the maintain the components in position during initial bonding ofthe entire appliance.

In yet another alternative, the molar tube 40 may have an opening on thedistal side permitting a tapered end 32 of the rod 30 to exit outthrough this opening.

Although the embodiments shown herein show a tapered end 32 to the rod30 and a tapered interior of the molar tube 44, from mesial to distal itis also possible to have other shapes to initiate a lateral slidingforce to be exerted on the molar 12.

Although the embodiments shown herein demonstrate the distal section ofthe rod may be seated into the molar tube from an occlusal directionthere may be instances the rod can also be seated into the molar tubefrom the gingival direction where a separate gingival cap 72 canpossibly be laser-welded, or brazed to the molar tube 40 to secure therod segment into the molar tube as shown in FIG. 13.

In some embodiments, the interior of the molar tube may be cone-shape,funnel (FIGS. 1-6), keyhole shape (FIGS. 7A-7C), or sinusoidal in FIG.7D, a pyramid, a prism, or a funnel. For example, the interior may be atriangular prism or pyramid, a rectangular pyramid or prism, or othershape of pyramid or prism known in the art. The interior and exterioredges of the cone, funnel, keyhole, sinusoidal, funnel, pyramid or prismmay be smoothed including at the corners, or chamfered to reduce edgesthat may prevent interference with rod movement, or prevent irritationinside the mouth respectively.

Although the embodiments herein show a distalizer for the patient'sleft-handed side of the mouth, the distalizer may be inverted to providea distalizer for the right-hand side of the mouth.

Although the embodiments herein show a distalizer for Class IIcorrection, the distalizer can be placed on the lower canine and lowermolar for Class III correction with a separate traction elastic attachedto a separate button attachment at the upper first molar.

Although the embodiments here demonstrate the orthodontic applianceplaced on a canine and a molar, the orthodontic appliance may be madeshorter so that is may be applied to different pairs of teeth. Inanother alternative, the attachment bracket may be placed on a mesialtooth with suitable root strength, and the molar tube may be possiblyplaced on any suitable distal tooth.

The embodiments described herein are only examples and are not intendedto limit the claims. One of skill in the art would be able to adapt thedescription herein and substitute equivalent elements performing thesame or similar function.

The invention claimed is:
 1. An orthodontic appliance for orthodontictreatment of a posterior maxillary sector extending from a canine toothto a molar tooth on the same side of the maxilla, comprising: a molartube affixable to the molar tooth and having an opening on the mesialside to an interior of the molar tube; a canine attachment bracketcomponent affixable to the canine tooth; a curved rod extending from thecanine attachment bracket component towards the molar tube in amesiodistal direction, the curved rod comprising an engagement featurecoupled to a retention feature of the molar tube, a distal end of thecurved rod engaging the interior of the molar tube; a hook, located onthe canine attachment bracket component or on the curved rod, forattachment to a traction elastic; and a push flange lever, located at adistal end of the curved rod for engaging a mesial end of the molar tubeto exert a distal force on the molar tooth when under a force of thetraction elastic on the hook; wherein the push flange lever engages themesial end of the molar tube before the engagement feature abuts a backwall of the molar tube.
 2. The orthodontic appliance according to claim1, wherein the molar tube opening is rectangular with rounded corners.3. The orthodontic appliance according to claim 1, wherein the interiorof the molar tube tapers in a mesiodistal direction from the opening. 4.The orthodontic appliance according to claim 1, wherein the molar tubeopening is narrower in an occlusal-gingival direction than in abuccal-lingual direction.
 5. The orthodontic appliance according toclaim 1, wherein the opening narrows in the buccal-lingual direction andin the mesial to distal direction, and the opening is relativelyrectangular in shape through a cross-sectional view in anocclusal-gingival direction.
 6. The orthodontic appliance according toclaim 1, wherein the curved rod engages a tapered end of the interior ofthe molar tube.
 7. The orthodontic appliance according to claim 1,further comprising a restriction feature maintaining the engagementfeature within the retention feature.
 8. An orthodontic appliance fororthodontic treatment of a posterior maxillary sector extending from acanine tooth to a molar tooth on the same side of a maxilla, comprising:a molar tube affixable to the molar tooth and having an opening on themesial side to an interior of the molar tube and an aperture on thedistal side; a canine attachment bracket affixable to the canine tooth;a curved rod extending from the canine attachment bracket in amesiodistal direction; a hook, located on the canine attachment bracketor on the curved rod, for attachment to a traction elastic; wherein thecurved rod passes through the molar tube entering at the opening andexits at the aperture; wherein a distal end portion of the curved rodfrictionally engages the molar tube to exert a distal force on the molartooth when under force of the traction elastic on the hook; and whereina tapered end of the curved rod initially aligns with the buccal wall ofthe molar tube and during treatment becomes aligned with a lingual wallof the molar tube.
 9. The orthodontic appliance according to claim 8,further comprising a blocking feature at a distal end of the curved rodfor preventing the curved rod from being removed from the molar tube.10. The orthodontic appliance according to claim 9, wherein the curvedrod tapers at the distal end.
 11. The orthodontic appliance according toclaim 8, wherein the canine attachment bracket comprises an orthodontictube containing an archwire slot therethrough in the mesiodistaldirection, the archwire slot being sized for permitting the insertion ofan archwire to pass mesiodistally from the canine attachment bracketinto at least one premolar bracket.
 12. The orthodontic applianceaccording to claim 8, further comprising a push flange lever, located atthe distal portion of the curved rod for engaging a mesial end of themolar tube when the curved rod is moved distally under the force of thetraction elastic on the hook.
 13. The orthodontic appliance according toclaim 12, wherein the push flange lever is offset with respect to thecurved rod such that the push flange lever engages a mesial edge of awall of the molar tube when the curved rod is moved distally under theforce of the traction elastic.
 14. An orthodontic appliance fororthodontic treatment of a posterior maxillary sector extending from acanine tooth to a molar tooth on the same side of the maxilla,comprising: a molar tube affixable to the molar tooth and having anopening on the mesial side to an interior of the molar tube; a canineattachment bracket affixable to the canine tooth; a curved rod extendingfrom the canine attachment bracket towards the molar tube in amesiodistal direction, the curved rod comprising an engagement featurecoupled to a retention feature of the molar tube; a hook, located on thecanine attachment bracket or on the curved rod, for attachment to atraction elastic; and a push flange lever, located at a distal end ofthe curved rod for engaging a mesial end of the molar tube to exert adistal force on the molar tooth when under a force of the tractionelastic on the hook; wherein the push flange lever engages the mesialend of the molar tube before the engagement feature abuts a back wall ofthe molar tube.
 15. The orthodontic appliance according to claim 14,wherein the hook is located on the curved rod between the canineattachment bracket and the molar tube.
 16. The orthodontic applianceaccording to claim 15, wherein the hook is located on a curved portionof the rod.
 17. The orthodontic appliance according to claim 14, whereinthe canine attachment bracket comprises an orthodontic tube containingan archwire slot therethrough in the mesiodistal direction, the archwireslot being sized for permitting the insertion of an archwire to passgenerally mesiodistally from the canine attachment bracket into at leastone premolar bracket.
 18. The orthodontic appliance according to claim14, wherein the push flange lever is offset with respect to the curvedrod such that the push flange lever engages a mesial edge of a wall ofthe molar tube when the curved rod is moved distally under the force ofthe traction elastic.
 19. The orthodontic appliance according to claim14, wherein the engagement feature has a spherical shape and, whereinthe retention feature is a spherical void sized slightly larger than theengagement feature.
 20. The orthodontic appliance according to claim 14,wherein the engagement feature has a ellipsoidal shape and the retentionfeature is a generally ellipsoidal void sized slightly larger than theengagement feature.
 21. The orthodontic appliance according to claim 14,wherein the engagement feature is D-shaped and the retention feature isa generally sinusoidal void with at least two chambers sized slightlylarger than the engagement feature.